Navigating the complexities: a case report on the varied presentation of lupus vulgaris

A 16-year-old female presented with an asymptomatic lesion in the right axilla, evolving over six months into a scaly, erythematous to brownish-colored plaque with associated axillary lymphadenopathy. Routine investigations revealed mild anemia, elevated erythrocyte sedimentation rate (ESR), and a positive Mantoux test. Histopathological examination confirmed lupus vulgaris, characterized by tuberculoid granulomas within the superficial dermis. Treatment with anti-tubercular therapy led to significant lesion improvement. Lupus vulgaris, a form of cutaneous tuberculosis, presents varied clinical features and poses diagnostic challenges. Early recognition and prompt treatment are essential to prevent morbidity and scarring. This case highlights the importance of considering lupus vulgaris in differential diagnosis of atypical cutaneous lesions, contributing to better disease management and reduced morbidity.